-- RadioGraphics 1997; 17: 1497-1526

Figure 18: Primary CNS lymphoma in a 67-year-old woman who developed a headache while undergoing coronary angiography. Panel A Unenhanced axial CT scan shows a soft-tissue mass (white arrow) outside the skull and a mildly high-attenuation extraaxial mass (black arrow). A thin crescent of high attenuation (arrowhead) is seen more posteriorly along the inner table of the skull. Diffuse sulcal effacement of the left cerebral hemisphere, near complete effacement of the left lateral ventricle posterior horn, and midline shift to the right are also present. Panel B Contrast-enhanced axial CT scan shows homogeneous enhancement of the scalp and extraaxial masses. Panel C Unenhanced axial T1-weighted MR image shows the same features seen in A and B. The extraaxial mass (black arrow) and scalp mass (white arrow) are isointense relative to gray matter. Panel D, Panel E Contrast-enhanced axial (D) and coronal (E) T1-weighted MR images show intense enhancement of the extraaxial lesion (black arrows) that covers a greater area than suspected on the CT scans in a dural or subdural location. In addition, skull extension is strongly favored because of the mottled enlargement of the diploic space (white arrow in D) and extension of enhancement from the intracranial components (white arrow in E). At surgery, the temporal muscle, temporal bone, dura mater, and subdural space were all involved with a grayish-yellow mass pathologically confirmed to be lymphoma.

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